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Are there any reasons for painful sex that aren’t related to menopause?

ANSWER

Non-menopausal reasons for painful sex can include:

Vaginismus. Fear of painful sex may cause you to involuntarily tighten your vaginal muscles. This can make intercourse impossible. You may also feel pain when you have a pelvic exam or use a tampon.

Vulvodynia. The outside of your vagina may sting or burn when it’s touched or during sex. This condition can affect women of any age.

Skin conditions. Eczema, psoriasis, lichen sclerosis

SOURCES:

Lauren Streicher, MD, clinical professor, department of obstetrics and gynecology, Northwestern University School of Medicine; founder and director, Northwestern Medicine Center for Menopause, Northwestern Medicine Center for Sexual Health.

Kathleen Green, MD, assistant professor, department of obstetrics and gynecology, University of Florida College of Medicine.

Alyssa Dweck, MD, gynecologist, CareMount Medical Group; medical consultant, Massachusetts General Hospital.

Laurie Mintz, PhD, sexual psychologist; professor, department of psychology, University of Florida.

Ellen Barnard, MSW, certified sexuality educator; co-owner, A Woman’s Touch Sexuality Resource Center, Madison, WI.

The North American Menopause Society: “Pain with Penetration,” “Illness, Medical Problems, Medications,” “Pain in the Vulva or Pelvis,” “Sex Therapy and Counseling.” 

Pain Research and Management: “Dyspareunia in postmenopausal women: A critical review.”

Harvard Health Publishing: “Managing postmenopausal vaginal atrophy,” “Postmenopausal bleeding: Don’t worry — but do call your doctor.” 

Mayo Clinic Proceedings: “Recognition and Management of Nonrelaxing Pelvic Floor Dysfunction.”

UpToDate: “Patient education: Vaginal dryness (Beyond the Basics).”

Journal of Women’s Health: “Sexual Desire During the Menopausal Transition and Early Postmenopause: Observations from the Seattle Midlife Women’s Health Study.”

Mayo Clinic: “Women’s Wellness: Painful sex after menopause.”

Cleveland Clinic: “Pelvic Floor Rehabilitation.”

Reviewed by Traci C. Johnson on January 30, 2020

SOURCES:

Lauren Streicher, MD, clinical professor, department of obstetrics and gynecology, Northwestern University School of Medicine; founder and director, Northwestern Medicine Center for Menopause, Northwestern Medicine Center for Sexual Health.

Kathleen Green, MD, assistant professor, department of obstetrics and gynecology, University of Florida College of Medicine.

Alyssa Dweck, MD, gynecologist, CareMount Medical Group; medical consultant, Massachusetts General Hospital.

Laurie Mintz, PhD, sexual psychologist; professor, department of psychology, University of Florida.

Ellen Barnard, MSW, certified sexuality educator; co-owner, A Woman’s Touch Sexuality Resource Center, Madison, WI.

The North American Menopause Society: “Pain with Penetration,” “Illness, Medical Problems, Medications,” “Pain in the Vulva or Pelvis,” “Sex Therapy and Counseling.” 

Pain Research and Management: “Dyspareunia in postmenopausal women: A critical review.”

Harvard Health Publishing: “Managing postmenopausal vaginal atrophy,” “Postmenopausal bleeding: Don’t worry — but do call your doctor.” 

Mayo Clinic Proceedings: “Recognition and Management of Nonrelaxing Pelvic Floor Dysfunction.”

UpToDate: “Patient education: Vaginal dryness (Beyond the Basics).”

Journal of Women’s Health: “Sexual Desire During the Menopausal Transition and Early Postmenopause: Observations from the Seattle Midlife Women’s Health Study.”

Mayo Clinic: “Women’s Wellness: Painful sex after menopause.”

Cleveland Clinic: “Pelvic Floor Rehabilitation.”

Reviewed by Traci C. Johnson on January 30, 2020

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What does your doctor need to know to treat painful sex after menopause?

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